1/25. Antegrade continence enema for the treatment of neurogenic constipation and fecal incontinence after spinal cord injury.OBJECTIVE: To describe the effects of an antegrade continence enema stoma formed in a paraplegic man with intractable constipation and fecal incontinence. DESIGN: Case report. SETTING: spinal cord injury unit, veterans Affairs hospital. PARTICIPANTS: spinal cord injury (SCI) patient with T12 paraplegia. INTERVENTION: Surgical formation of antegrade continence enema stoma. MAIN OUTCOME MEASURES: time of bowel program care, ease of fecal elimination, safety of procedure. RESULTS: Bowel care time was decreased from 2 hours to 50 minutes daily; 6 bowel medications were discontinued; fecal incontinence was eliminated; and no surgical or medical side effects noted after the procedure. CONCLUSION: The antegrade continence enema procedure is a safe and effective means of treating intractable constipation and fecal incontinence in the adult SCI patient. This option should be considered for those persons in whom medical management of bowel care has been unsuccessful.- - - - - - - - - - ranking = 1keywords = fecal incontinence, incontinence (Clic here for more details about this article) |
2/25. Laparoscopic cecostomy for anterior ectopic anus with constipation: a new and technical proposal.A female patient of 26 years of age with faecal incontinence is presented. The anal opening was anteriorly located just posterior to the vagina. This had resulted in overflow faecal incontinence due to severe chronic constipation. NMR showed a normal musculature of the pelvic floor and sphincter. Since the patient did not agree to surgery, laparoscopic cecostomy was performed for the first time for antegrade rinsing.- - - - - - - - - - ranking = 0.0029178021718686keywords = incontinence (Clic here for more details about this article) |
3/25. Improvement in neurogenic bladder after the antegrade continence enema procedure.A child with neurogenic bladder and bowel underwent an antegrade continence enema procedure for fecal incontinence and severe constipation. She subsequently demonstrated an improvement in her neurogenic bladder and urinary incontinence.- - - - - - - - - - ranking = 0.14431604394308keywords = fecal incontinence, incontinence (Clic here for more details about this article) |
4/25. Managing faecal retention and incontinence in neurodisability.The large number of patients with faecal retention and/or incontinence in continuing care wards and rehabilitation units presents a considerable challenge. In order to maintain dignity and minimize the unpleasant odour so commonly associated with these wards and units, effective bowel management should be planned for individual patients. For an effective bowel management regime a team approach should be adopted, involving, where possible, the patient and carer as well as all the health professionals administering the care. Two case studies illustrate the use of assessment and management of bowel problems in patients with severe complex neurodisability. Bowel dysfunction in this patient population, in general, is poorly covered in the literature. The present article, by relating theory to practice, offers information and guidance for nurses working with patients who have bowel-related problems.- - - - - - - - - - ranking = 0.0072945054296716keywords = incontinence (Clic here for more details about this article) |
5/25. Radiographic, computed tomographic and histopathologic appearance of a presumed spinal chordoma in a dog.A 4-year-old Labrador Retriever presented for urinary incontinence and constipation of 2 weeks duration. There was a tender abdomen, lumbar pain and conscious proprioceptive deficits in both pelvic limbs. Depressed pelvic limb reflexes were present consistent with a lower motor neuron lesion. In radiographs of the lumbar spine there was narrowing of the intervertebral disc space at L5-L6 with irregular, multifocal areas of mineralized opacities dorsal to the intervertebral disc space, presumably within the vertebral canal. On computed tomography, an intramedullary, partially mineralized mass was identified in the spinal cord at the level of caudal L5 through cranial L6. At necropsy there was a four-centimeter enlarged, irregular segment of spinal cord at the level of L5-L6. When sectioned, the spinal cord bad a mineralized texture. Histologically there were variable sized cells that were stellate in appearance with vacuolated cytoplasm (physaliferous cells) and mucinous background consistent with a chordoma. chordoma is a rare, skeletal neoplasm that originates from mesoderm-derived notochord and has been reported in humans and animals. Extraskeletal development of a chordoma within the spinal cord is a rare manifestation of this neoplasm. However, based on other reports in dogs, solitary extraskeletal locations of chordomas may be the typical expression of this neoplasm in the dog. Differentiation of similar histologically appearing tumors, such as a parachordoma or myxoid chondrosarcoma, will require immunohistochemical characterization of these tumors in veterinary patients.- - - - - - - - - - ranking = 0.0014589010859343keywords = incontinence (Clic here for more details about this article) |
6/25. Anticipation and early detection can reduce bowel elimination complications.Adequate bowel elimination is essential for physiologic functioning and daily comfort of older patients. A careful assessment of normal bowel elimination patterns will help to prevent unnecessary bowel problems when the older patient is hospitalized or admitted to a long-term care facility. constipation and incontinence are the two most common bowel elimination problems affecting older adults. Many simple nursing interventions exist that will help to prevent major complications that can occur when constipation or incontinence is present.- - - - - - - - - - ranking = 0.0029178021718686keywords = incontinence (Clic here for more details about this article) |
7/25. Spinal Burkitt's lymphoma manifesting as nocturnal abdominal pain and constipation: a case report.A 3-year-old boy presented at the taiwan Adventist Hospital in Taipei with nocturnal epigastric pain and constipation. Abdominal X-ray showed colonic faecal impaction. Abdominal sonography showed gastric stasis with thickened pyloric wall and dilated rectosigmoid colons. The mouth-to-anus transit time (MATT) was prolonged. endoscopy showed pale gastric mucosa, atony of pylorus and widening of the duodenal bulb. Three weeks after the onset of abdominal pain, he developed urinary incontinence and rapidly deteriorating paraplegia of lower limbs. magnetic resonance imaging (MRI) showed an extradural intraspinal mass of T5-T8 and a soft tissue mass in the right superior mediastinum. After a laminectomy and tumour excision, the patient's symptoms improved quickly. The pathology revealed Burkitt's lymphoma. This is the first report of nocturnal abdominal pain and constipation as the initial manifestation of spinal Burkitt's lymphoma.- - - - - - - - - - ranking = 0.0014589010859343keywords = incontinence (Clic here for more details about this article) |
8/25. A case of occult intrasacral meningocele presented with atypical bowel symptoms.CASE REPORT: We report a case of an occult intrasacral meningocele. An 11-year-old boy presented with atypical bowel symptoms, severe constipation, and stool incontinence. Magnetic resonance (MR) imaging disclosed an intrasacral cyst containing cerebrospinal fluid (CSF). We diagnosed an occult intrasacral meningocele and performed perforation of the cyst and closure of the fistula. The patient was free from constipation and stool incontinence after the operation. DISCUSSION: We discuss the clinical features and neuroradiological findings of this rare condition.- - - - - - - - - - ranking = 0.0029178021718686keywords = incontinence (Clic here for more details about this article) |
9/25. Laparoscopic sacral colpoperineopexy for treatment of perineal body descent and vaginal vault prolapse.Perineal body descent has been linked to pudendal nerve injury and anorectal disorders, including constipation, rectal pain, and fecal incontinence. Open sacral colpoperineopexy has been described for the treatment of perineal descent. We present a technique for laparoscopic sacral colpoperineopexy and highlight this approach with accompanying video segments.- - - - - - - - - - ranking = 0.14285714285714keywords = fecal incontinence, incontinence (Clic here for more details about this article) |
10/25. The use and rationale of selective alpha blockade in children with non-neurogenic neurogenic bladder dysfunction.INTRODUCTION: We present here a long-term observation of 2 children with a rare syndrome with a non-neurogenic neurogenic bladder dysfunction (Hinman's syndrome), and we investigated the safety and efficacy of long-term use of terazosine in association with prophylactic antibiotics, timed voiding and a bowel regimen. MATERIALS AND methods: Two children, 7 years-old (22 kg) and 11 years-old (36 kg) presented in 1997 to our pediatric urology clinic with symptoms of urgency, frequency, urge incontinence and nocturnal enuresis. Both children were placed in a regimen of terazosine (starting with 0.5 mg increasing until 2 mg). RESULTS: There were no significant side effects throughout the entire treatment. The first 7-year old boy however developed some dizziness when the dose of terazosine was increased to 2 mg (after 4 weeks of administrating 1 mg), and this disappeared immediately when the dosage was reduced back to 1 mg daily. The urgency symptoms improved in both boys after 3 weeks of 1 mg terazosine. The secondary enuresis in the 11 year-old boy resolved after 2 months of 2 mg terazosine. CONCLUSION: It is possible to say that the alpha-blocker medication, terazosine can be administered safely to children with a non-neurogenic bladder dysfunction, also known as the Hinman's syndrome. These results have shown that dysfunctional voiding, postvoiding residual and upper tract involvement can disappear over time when long term terazosine is given in combination with timed voiding, prophylactic antibiotic therapy and treatment of the associated constipation. Our observations also suggest a permanent effect after discontinuing the medication.- - - - - - - - - - ranking = 0.0014589010859343keywords = incontinence (Clic here for more details about this article) |
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